There are more than 30 million people who have chronic conditions, and many of them are on Medicaid.
You might think you’d know which doctor to go to for your chronic conditions.
But a study published this week suggests that you might be surprised to learn that the answers to those questions might vary widely.
In a paper published in the American Journal of Public Health, researchers analyzed data from more than 10,000 Americans from 2006 to 2014, using the National Health Interview Survey, the first national health survey to include the answers of nearly 2.4 million Americans.
What they found was that the vast majority of Americans had no idea which doctors they should seek out for health care.
More than half of respondents said they’d never heard of any of the top-ranked doctors, with the average score for the top 100 providers being 11 out of 10.
When asked if they’d recommend any of their peers for a chronic condition, just 11 percent of respondents answered yes.
And while most people are not aware of the medical literature on the topic, only a quarter of respondents knew that the Mayo Clinic is one of the most prominent health centers in the country.
The researchers also looked at data from Medicare, which tracks medical spending, and found that about a quarter or 25 percent of the respondents said their doctor had an affiliation with one of three healthcare providers: A health insurer, a private practice, or a health maintenance organization.
A third said they had heard of no providers.
There were some interesting patterns.
When people were told they were choosing between a “big four” of providers (Aetna, Humana, Cigna, and UnitedHealth Group), more than half said they would not choose either a private or a public health insurer.
And about half of the people said they wouldn’t consider a private practitioner.
These findings suggest that while many people have a good idea about the quality of their doctor, they may be misinterpreting their choices, and might even be misinformed about what the doctor is doing.
The study’s authors, David B. Lippman, a professor of health policy and management at Columbia University and a member of the American Medical Association’s (AMA) Board of Directors, and Robert A. Weil, a senior fellow at the Brookings Institution and the National Bureau of Economic Research, note that most doctors don’t advertise their affiliation with any of these providers, and that a few of the largest health systems in the United States do.
“The idea that physicians who advertise are the only ones in the profession who know how to practice the best is not supported by the evidence,” Lippmen says.
And in some cases, the practice of medicine may be less than good, he says.
“There are lots of things that the profession needs to improve to improve the patient experience,” Lipsman says.
He also notes that many of the physicians we talk to about their work are working in the private sector.
“They’re not the best in the world.
But the reason why they’re in the field is because they’re the only one who knows how to do the best thing in the business,” he says, adding that some physicians may be biased against certain groups of people.
The American Medical Board of Trustees and Congress has been urging the AMA to do more to improve health care access for a decade.
The AMA’s role in the AMA is to protect the health and well-being of all Americans, and to advocate for quality care, says John R. Gittings, director of the Center for Health and the Public at the AMA.
The new research also raises the possibility that the lack of knowledge about chronic conditions may be a result of the way that doctors are trained and paid.
“We are not trained to be clinicians,” Gitting says.
Instead, we’re trained to think that what we do is important and worthwhile and that our patients deserve good care.
That doesn’t seem to be the case.
“I think there are ways that we can improve the way doctors are paid to be better,” says Weil.
But he also notes, “I don’t think there is any way to say that this is a good thing.”
He adds that the AMA’s stance on paying for care has been to oppose the practice until the system changes, and the AMA and other organizations have tried to do just that.
But there is no doubt that many doctors who are paid well and who treat their patients with care, even if they have a bad reputation, could be better equipped to help their patients in other ways, such as providing referrals for specialized care.
“In the long run, that could be a positive for the patient, and it could also be a negative for the providers,” Weil says.
Still, the study does provide some clues about how we might be able to change our doctor-patient relationship.
Some of the researchers did find that the majority of physicians who have a public affiliation with a healthcare organization were doing the best they could in their areas of practice. In other